Renal Transplantation in Areas of Armed Conflict

Kidney transplantation (KT) is the treatment of choice for patients with end-stage renal disease. KT recipients are considered a vulnerable patient population because of their dependence on expensive immunosuppression drugs from the time of transplantation until graft failure. Management of KT recipients is complex, and therefore requires a sustainable infrastructure that is equipped to provide reliable medical care and continued access to immunosuppressive drugs. This structure, especially in third-world countries, relies on elements that may be easily disrupted during times of armed conflict. This results in a decrease in KT rate and interruption in access to immunosuppressive drugs, which may lead to poor KT outcomes. This review summarizes our experiences and reviews other literature published regarding the status and management of KT recipients in Syrians as an example of an armed conflict zone.